Abstract：
BACKGROUND: Rapid eye movement (REM) sleep behaviour disorder (RBD) is a parasomnia characterised by the loss of REM sleep muscle atonia and the enactment of dreams. Acute RBD associated with alcohol withdrawal syndrome is known, but the studies are limited, particularly on its neurobiological underpinnings and management alongside the withdrawal state. This work attempts to address this using a case study and relevant literature review.
METHODS: A 40-year-old male with alcohol dependence (for 20 years) reported new-onset terrifying nightmares and violent behaviours in his sleep precipitated by alcohol withdrawal states for the last 18 months. The polysomnographic finding of REM-without-atonia supported the diagnosis of RBD. He was treated with chlordiazepoxide 100 mg/day (gradually tapered and stopped) and thiamine supplements. Post-discharge, he remained abstinent and symptom-free during the three months of follow-up.
CONCLUSIONS: RBD related to alcohol withdrawal syndrome has been previously described in a few anecdotal reports. Sudden withdrawal from central nervous system suppressants like alcohol is hypothesised to cause a homeostatic imbalance in gamma-aminobutyric acid (GABA) pathways and \'REM rebound\', resulting in the clinical and polysomnographic picture of RBD. Benzodiazepines have been found to be useful in both RBD and alcohol withdrawal.
CONCLUSIONS: Alcohol withdrawal syndrome may present with acute RBD, which can be treated with a short course of benzodiazepine. However, further studies are needed to explore the long-term course of RBD in these patients.
METHODS: A 40-year-old male with alcohol dependence (for 20 years) reported new-onset terrifying nightmares and violent behaviours in his sleep precipitated by alcohol withdrawal states for the last 18 months. The polysomnographic finding of REM-without-atonia supported the diagnosis of RBD. He was treated with chlordiazepoxide 100 mg/day (gradually tapered and stopped) and thiamine supplements. Post-discharge, he remained abstinent and symptom-free during the three months of follow-up.
CONCLUSIONS: RBD related to alcohol withdrawal syndrome has been previously described in a few anecdotal reports. Sudden withdrawal from central nervous system suppressants like alcohol is hypothesised to cause a homeostatic imbalance in gamma-aminobutyric acid (GABA) pathways and \'REM rebound\', resulting in the clinical and polysomnographic picture of RBD. Benzodiazepines have been found to be useful in both RBD and alcohol withdrawal.
CONCLUSIONS: Alcohol withdrawal syndrome may present with acute RBD, which can be treated with a short course of benzodiazepine. However, further studies are needed to explore the long-term course of RBD in these patients.
摘要：
背景：快速眼动（REM）睡眠行为障碍（RBD）是一种失眠症，其特征是REM睡眠肌肉失功和做梦。与酒精戒断综合征相关的急性RBD是已知的，但是研究是有限的，特别是在其神经生物学基础和管理与退出状态。这项工作试图通过案例研究和相关文献综述来解决这个问题。
方法：一名患有酒精依赖的40岁男性（长达20年）报告说，在过去的18个月中，他的睡眠中出现了新的可怕噩梦和暴力行为，这些行为是由酒精戒断状态引起的。无张力的REM多导睡眠图发现支持RBD的诊断。他用氯二氮卓100毫克/天（逐渐减量并停止）和硫胺素补充剂治疗。放电后,在3个月的随访期间,他保持戒断和无症状.
结论：与酒精戒断综合征相关的RBD先前已在一些轶事报告中描述过。假设突然从中枢神经系统抑制剂如酒精中撤出会导致γ-氨基丁酸（GABA）途径和“REM反弹”的稳态失衡，导致RBD的临床和多导睡眠图。已经发现苯二氮卓类药物在RBD和酒精戒断中都是有用的。
结论：酒精戒断综合征可能表现为急性RBD，可以用短程苯二氮卓类药物治疗。然而,需要进一步的研究来探讨这些患者RBD的长期病程.
方法：一名患有酒精依赖的40岁男性（长达20年）报告说，在过去的18个月中，他的睡眠中出现了新的可怕噩梦和暴力行为，这些行为是由酒精戒断状态引起的。无张力的REM多导睡眠图发现支持RBD的诊断。他用氯二氮卓100毫克/天（逐渐减量并停止）和硫胺素补充剂治疗。放电后,在3个月的随访期间,他保持戒断和无症状.
结论：与酒精戒断综合征相关的RBD先前已在一些轶事报告中描述过。假设突然从中枢神经系统抑制剂如酒精中撤出会导致γ-氨基丁酸（GABA）途径和“REM反弹”的稳态失衡，导致RBD的临床和多导睡眠图。已经发现苯二氮卓类药物在RBD和酒精戒断中都是有用的。
结论：酒精戒断综合征可能表现为急性RBD，可以用短程苯二氮卓类药物治疗。然而,需要进一步的研究来探讨这些患者RBD的长期病程.
